Will Insurance Pay For My Braces?

Unlike medical insurance, dental insurance isn’t a “mandate.” While the majority of employers offer this valuable benefit and, currently, dental insurance is available through the Affordable Care Act (ACA), there’s no penalty if you or your kids don’t opt in. And if you do have dental insurance? While there are plenty of perks -- low- and no-cost treatments and preventative check ups, for example -- benefits tend to vary from provider to provider and, even, state to state.

Many dental insurance plans do, though, cover braces and orthodontia in certain situations. For example, if you or your child have issues chewing, or you’re experiencing pain from existing dental issues, corrective measures including braces are more likely to be covered. If it’s simply cosmetic? It’s harder to get braces covered, even partially.

Confirming Coverage

When braces are covered, it’s important to confirm what specific elements are included in your plan. Contact your dental insurance provider to review key elements of yours or your child’s orthodontic treatment, including:

Exams before and during treatment
Braces and other treatment needs
Retainers
Post-treatment appointments and ongoing needs

In some cases, insurance may cover different portions of these and other orthodontic needs.

Enhanced Insurance Options

That said, other policies cover a broader-range of braces and orthodontia. A number of plans, now, cover traditional braces as well as options like Invisalign, either providing significant cost savings or a fixed contribution meant to reimburse your out-of-pocket. Private individual and family plans may be more flexible overall, as are optional dental insurance add-ons, designed specifically for orthodontia and other extended treatment needs.

To ensure you’re getting the most accurate and up-to-date coverage information, contact your insurance provider. The Southern Orthodontic Specialists team can also help determine what’s “in” and what’s not, by providing you with comprehensive information surrounding upcoming treatments and care plans. Together, this will ensure you have the intel and access you need to manage braces and beyond.